Primary care is the backbone of the NHS. It faces unprecedented challenges and opportunities. We work with GP practices supporting them as they formulate and implement their strategies for meeting current challenges and taking advantage of new opportunities. We would be delighted to talk with you about options you are considering and help you design and implement the right solution for your practice.

"The strength of British general practice is in its personal response to a dedicated patient list; its weakness is its failure to develop consistent systems that free up time and resources to devote to improving care for patients. The current shift towards groups of practices working together offers a major opportunity to tackle the frustrations that so many people feel in accessing care in general practice."

The General Practice Forward View, NHS England, April 2016.

Working collaboratively with other practices is key to achieving a sustainable practice that can deal with rising workloads, tighter financial constraints, increasing list sizes, staff and partner recruitment and retention and contract pressures.

Practices working together at scale is regarded increasingly as a solution. We often hear GPs and practice managers referring to forming a "super practice", or a "joint venture", but these terms mean different things to different GPs, even within the same practice, so what are the options in legal terms?

In reality, there is a whole spectrum of options. The main options are:

  • Contractual joint venture/collaboration in which a number of practices or organisations participate (eg an Accountable Care System)
  • Corporate joint venture, which involves a number of practices forming a new business that is owned by the practices
  • Merger or acquisition of practices

Being bigger does not necessarily result in being "super". Selecting the right model will enable you to build a stronger platform for practice development the benefits of which might include: access to pilot and more permanent primary care financial support from NHS England/ the CCGs; alleviation of access and capacity problems through accessing a larger and potentially more flexible workforce; development of new and/or better services by enabling investment in other professionals (nurses, paramedics, psychologists etc,) and new facilities (e.g. diagnostics; physiotherapy; gym; ophthalmology, minor injuries etc); opportunities for better primary care integration with other services in accountable care systems/organisations; and of course, back office efficiency and savings.

Selecting the correct legal form and governance arrangement and putting in place incentives that motivate practitioners to achieve the desired changes are key issues that we can help with. You may already have decided what your version of "super" looks like. If not, we can help advise and create your new model.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.